Is Mycoplasma (Mycoplasma pneumoniae) infection contagious?

From the Guidelines

Yes, Mycoplasma is contagious, and it can spread through respiratory droplets when an infected person coughs or sneezes, as well as through close contact with infected individuals, especially in crowded settings. Mycoplasma bacteria, particularly Mycoplasma pneumoniae, which causes respiratory infections, can be transmitted through these means, with an incubation period of 2-3 weeks, and people remaining contagious for 1-2 weeks after symptoms begin 1. Other Mycoplasma species, like Mycoplasma genitalium, can be sexually transmitted.

Key Points to Consider

• The transmission of Mycoplasma pneumoniae is a significant concern, especially in crowded settings like schools, dormitories, and military barracks, where close contact with infected individuals increases the risk of transmission 1.
• To prevent the spread of Mycoplasma, it is essential to practice good hygiene, including handwashing, covering coughs and sneezes, avoiding sharing personal items, and considering wearing masks in crowded settings if Mycoplasma outbreaks are occurring.
• If diagnosed with a Mycoplasma infection, antibiotics like azithromycin, clarithromycin, or doxycycline are typically prescribed for 5-14 days, depending on the specific infection, as recommended by local guidelines for the treatment of pneumonia in Taiwan 1.
• The choice of empirical antimicrobials for community-acquired pneumonia (CAP) should take into consideration the local epidemiology, and a combination of a beta-lactam antibiotic plus a macrolide is recommended, or a combination of a beta-lactam antibiotic plus doxycycline, or monotherapy with a respiratory fluoroquinolone if resistance to Mycoplasma is a concern 1.

Prevention and Treatment

• Preventing the spread of Mycoplasma requires a combination of good hygiene practices, avoiding close contact with infected individuals, and wearing masks in crowded settings if necessary.
• Treatment of Mycoplasma infections typically involves antibiotics, and the choice of antibiotic should be guided by local guidelines and the specific infection being treated.
• It is essential to note that Mycoplasma pneumoniae is a common pathogen of community-acquired atypical pneumonia, and it does not usually lead to severe disease, but increased macrolide resistance is reported in some areas, especially in Asia 1.

From the Research

Contagiousness of Mycoplasma

• Mycoplasma genitalium infection is transmitted through direct mucosal contact 2.
• The infection can be spread through sexual contact, and asymptomatic infections are frequent 2.
• Symptoms of Mycoplasma genitalium infection in men include urethritis, dysuria, and discharge, while in women, symptoms include vaginal discharge, dysuria, or symptoms of pelvic inflammatory disease (PID) such as abdominal pain and dyspareunia 2.

Transmission and Prevention

• The transmission of Mycoplasma genitalium can be prevented by using barrier methods during sexual contact and by treating infected individuals with appropriate antibiotics 2, 3.
• Resistance-guided therapy using doxycycline followed by azithromycin or moxifloxacin has been shown to be effective in treating Mycoplasma genitalium infections 3.

Treatment and Resistance

• Azithromycin has a cure rate of 85-95% in macrolide-susceptible infections, while doxycycline has a cure rate of 30-40% 2.
• Moxifloxacin can be used as second-line therapy, but resistance is increasing 2, 3.
• Omadacycline has been shown to be highly active in vitro against Mycoplasma genitalium, including isolates resistant to other agents 4.